scholarly journals Continuum of Care UNAIDS Fast-Track Targets Evaluation of Patients Living with Human Immunodeficiency Virus Infection

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1249
Author(s):  
Cristian Jianu ◽  
Corina Itu-Mureşan ◽  
Adriana Violeta Topan ◽  
Irina Filipescu ◽  
Mihaela Elena Jianu ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Fast Track ◽  
Hiv Transmission ◽  
Strand Transfer ◽  
Nations Programme ◽  
United Nations Programme ◽  
Immunodeficiency Virus ◽  
Integrase Strand Transfer Inhibitors ◽  
Living With Hiv

The current study evaluated the progress of continuum healthcare for patients living with human immunodeficiency virus (HIV) infection from Cluj County in two moments, 2016 and 2020, and compared the results to the Fast-Track targets (FTTs) proposed by the Joint United Nations Programme (UNAIDS) on HIV/AIDS. By the end of 2020, 368 out of 385 confirmed HIV-positive patients from Cluj County were under surveillance in our center, representing almost 95% of the patients living with HIV and knowing their diagnosis, compared to 87.9% in 2016. Nearly 97% of those in active follow-up from Cluj County were under antiretroviral therapy (ART) in 2020, compared to 89% in 2016. The number of virally suppressed patients from those under ART was almost 94% in 2020, compared to 82.7% in 2016, and the increase is observed regardless of the ART regime. A shift towards integrase strand transfer inhibitors, with a higher efficacy, fewer adverse effects, and fewer drug interactions, is observed, which could contribute to the decrease in HIV transmission.

scholarly journals Modelling the epidemiologic impact of achieving UNAIDS fast-track 90-90-90 and 95-95-95 targets in South Africa

2019 ◽  
Vol 147 ◽  
Author(s):  
N. N. Abuelezam ◽  
A. W. McCormick ◽  
E. D. Surface ◽  
T. Fussell ◽  
K. A. Freedberg ◽  
...  
Keyword(s):  
South Africa ◽  
Human Immunodeficiency Virus ◽  
Fast Track ◽  
Viral Suppression ◽  
Hiv Transmission ◽  
Hiv Positive ◽  
Agent Based ◽  
Percentage Points ◽  
Immunodeficiency Virus ◽  
The Continuum

AbstractUNAIDS established fast-track targets of 73% and 86% viral suppression among human immunodeficiency virus (HIV)-positive individuals by 2020 and 2030, respectively. The epidemiologic impact of achieving these goals is unknown. The HIV-Calibrated Dynamic Model, a calibrated agent-based model of HIV transmission, is used to examine scenarios of incremental improvements to the testing and antiretroviral therapy (ART) continuum in South Africa in 2015. The speed of intervention availability is explored, comparing policies for their predicted effects on incidence, prevalence and achievement of fast-track targets in 2020 and 2030. Moderate (30%) improvements in the continuum will not achieve 2020 or 2030 targets and have modest impacts on incidence and prevalence. Improving the continuum by 80% and increasing availability reduces incidence from 2.54 to 0.80 per 100 person-years (−1.73, interquartile range (IQR): −1.42, −2.13) and prevalence from 26.0 to 24.6% (−1.4 percentage points, IQR: −0.88, −1.92) from 2015 to 2030 and achieves fast track targets in 2020 and 2030. Achieving 90-90-90 in South Africa is possible with large improvements to the testing and treatment continuum. The epidemiologic impact of these improvements depends on the balance between survival and transmission benefits of ART with the potential for incidence to remain high.

scholarly journals Outcomes of prevention of HIV mother-to-child transmission in Cipto Mangunkusumo Hospital

2012 ◽  
Vol 52 (5) ◽  
pp. 294
Author(s):  
Dina Muktiarti ◽  
Nia Kurniati ◽  
Arwin Akib ◽  
Zakiudin Munasir
Keyword(s):  
Human Immunodeficiency Virus ◽  
Risk Factor ◽  
Hiv Transmission ◽  
Pmtct Program ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Immunodeficiency Virus ◽  
Mother To Child ◽  
Prevention Of Hiv

Background Human immunodeficiency virus (HIV) infectionis increasing worldwide. One foute of HIV transmission is frommother to child, during pregnancy, delivery or breastfeeding.Prevention of mother􀁂to􀁂child transmission may be an effectivestrategy to reduce the cases of new HIV infections.Objectives To investigate the incidence of HIV infection ininfants born to mothers with HIV and who received prophylactictherapy at birth, as well as to note the outcomes of HIVinfectedchildren in this program.Methods This retrospective study was carried out over a 9􀁂yearperiod, from January 20 03 to December 2011. The participantswere HIVexposed infants who attended the HIV clinic, at theDepartment of Child Health, Cipto Mangunkusumo Hospital,Jakarta. Infants were treated according to the prevention ofmother􀁂to􀁂child transmission (PMTCT) protocol at CMH.Parents' and infants' data was recorded. The end point of thisstudy was recording of HIVinfection status in the infants.Results There were 238 infants included in this study. HIVinfection was confirmed in 6 (2.5%) infants, while 170 (71.4%)subjects were uninfected, and 62 (26.1%) subjects were lostto follow􀁂up. No subjects who underwent complete PMTCTmanagement were infected. Most subjects were male, full􀁂tenn,and delivered by caesarean section in our hospital. The mostfrequently observed parental risk factor was intravenous druguse. Maternal antiretroviral therapy (ART) was given duringpregnancy in most cases. Morbidities in all subjects were low.Conclusion The PMTCT program at CMH was effective forreducing the number ofHIVinfected infants from mothers withHIY. [Paediatrlndanes. 2012;52:294-9]. 

Reaching the Second and Third Joint United Nations Programme on Human Immunodeficiency Virus (HIV)/AIDS 90-90-90 Targets Is Accompanied by a Dramatic Reduction in Primary HIV Infection and in Recent HIV Infections in a Large French Nationwide HIV Cohort

2019 ◽  
Vol 71 (2) ◽  
pp. 293-300
Author(s):  
Adrien Le Guillou ◽  
Pascal Pugliese ◽  
François Raffi ◽  
André Cabie ◽  
Lise Cuzin ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
United Nations ◽  
Hiv Infection ◽  
Cell Count ◽  
Hiv Diagnosis ◽  
Cd4 Cell Count ◽  
Nations Programme ◽  
United Nations Programme ◽  
Immunodeficiency Virus ◽  
Cd4 Cell

Abstract Background In late 2013, France was one of the first countries to recommend initiation of combination antiretroviral therapy (cART) irrespective of CD4 cell count. Methods To assess the impact of achieving the second and third Joint United Nations Programme on HIV/AIDS 90-90-90 targets (ie, 90% of diagnosed people on sustained cART, and, of those, 90% virologically controlled) on human immunodeficiency virus (HIV) incidence, we conducted a longitudinal study to describe the epidemiology of primary HIV infection (PHI) and/or recent HIV infection (patients with CD4 cell count ≥500/mm3 at HIV diagnosis; (PRHI) between 2007 and 2017 in a large French multicenter cohort. To identify changes in trends in PHI and PRHI, we used single breakpoint linear segmented regression analysis. Results During the study period, 61 822 patients were followed in the Dat’AIDS cohort; 2027 (10.0%) had PHI and 7314 (36.1%) had PRHI. The second and third targets were reached in 2014 and 2013, respectively. The median delay between HIV diagnosis and cART initiation decreased from 9.07 (interquartile range [IQR], 1.39–33.47) months in 2007 to 0.77 (IQR, 0.37–1.60) months in 2017. A decrease in PHI (−35.1%) and PRHI (−25.4%) was observed starting in 2013. The breakpoints for PHI and PRHI were 2012.6 (95% confidence interval [CI], 2010.8–2014.4) and 2013.1 (95% CI, 2011.3–2014.8), respectively. Conclusions Our findings show that the achievements of 2 public health targets in France and the early initiation of cART were accompanied by a reduction of about one-third in PHI and PRHI between 2013 and 2017. Clinical Trials Registration NCT02898987.

Breastfeeding by Women Living With Human Immunodeficiency Virus in a Resource-Rich Setting: A Case Series of Maternal and Infant Management and Outcomes

2019 ◽  
Vol 9 (2) ◽  
pp. 228-231 ◽  
Author(s):  
N Nashid ◽  
S Khan ◽  
M Loutfy ◽  
J MacGillivray ◽  
M H Yudin ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Transmission ◽  
Healthcare Providers ◽  
Case Series ◽  
Virologic Suppression ◽  
Combination Antiretroviral Therapy ◽  
Breastfed Infants ◽  
Women Living With Hiv ◽  
Immunodeficiency Virus ◽  
Living With Hiv

Abstract The reduction in human immunodeficiency virus (HIV) transmission through breastmilk with maternal combination antiretroviral therapy (cART) has led many pregnant women living with HIV and healthcare providers to question exclusive formula feeding in resource-rich settings. Here, we describe cART prophylaxis in 3 breastfed infants whose mothers had sustained virologic suppression; all 3 of these infants remained uninfected.

scholarly journals Canary in the Coal Mine? Transmitted Mutations Conferring Resistance to All Integrase Strand Transfer Inhibitors in a Treatment-Naive Patient

2018 ◽  
Vol 5 (11) ◽  
Author(s):  
Kara S McGee ◽  
Nwora Lance Okeke ◽  
Christopher B Hurt ◽  
Mehri S McKellar
Keyword(s):  
Human Immunodeficiency Virus ◽  
Drug Resistance ◽  
Transmitted Drug Resistance ◽  
Strand Transfer ◽  
Naive Patient ◽  
Immunodeficiency Virus ◽  
Integrase Strand Transfer Inhibitors ◽  
Treatment Naïve ◽  
Transfer Inhibitor ◽  
Integrase Strand Transfer Inhibitor

Abstract Transmitted drug resistance to the integrase strand transfer inhibitor (INSTI) class of antiretrovirals is very rare. We present a case of a treatment-naive female patient with human immunodeficiency virus harboring resistance to all INSTIs, including bictegravir and dolutegravir.

scholarly journals CONDYLOMA LATA IN A 21-YEAR-OLD MALE TREATED WITH DOXYCYCLINE: A CASE REPORT

2014 ◽  
Vol 6 (2) ◽  
Author(s):  
Hendra Minarto
Keyword(s):  
Human Immunodeficiency Virus ◽  
Risk Factor ◽  
Case Report ◽  
Hiv Transmission ◽  
Treponema Pallidum ◽  
Initial Therapy ◽  
Secondary Syphilis ◽  
Immunodeficiency Virus ◽  
The World

Abstrak: Kondiloma lata merupakan salah satu manifestasi sifilis sekunder yang disebabkan oleh Treponema pallidum. Manifestasi klinis kondiloma lata berupa papul-papul berwarna putih atau keabuan pada daerah tubuh yang hangat dan lembab. Sifilis memerlukan perhatian serius karena penyakit ini merupakan salah satu faktor risiko transmisi human immunodeficiency virus (HIV) di seluruh dunia. Kami melaporkan satu kasus kondiloma lata pada seorang laki-laki berusia 21 tahun di daerah penis, skrotum, perineal, dan perianal sejak 2 bulan lalu, yang diterapi dengan doksisiklin 2 x 100 mg selama 30 hari. Pada pemeriksaan serologik awal didapatkan hasil reaktif untuk tes VDRL (1/256), tes RPR (1/512) dan tes TPHA (1/5120). Perbaikan signifikan terlihat setelah 30 hari terapi doksisiklin dimana semua lesi menghilang. Pemeriksaan serologik 3 bulan setelah awal terapi menunjukkan penurunan titer sebanyak empat kali lipat untuk tes VDRL (1/64), tes RPR (1/128), dan enam kali lipat untuk tes TPHA (1/640). Simpulan: Telah dilaporkan kasus kondiloma lata dengan diagnosis ditegakkan berdasarkan anamnesis, pemeriksaan fisik, dan serologik. Terapi doksisiklin selama 30 hari memberikan hasil yang memuaskan. Pemeriksaan serologik harus dilakukan pada bulan ke-6 dan 12 untuk monitoring keberhasilan terapi. Kata kunci: kondiloma lata, sifilis sekunder, Treponema pallidum, doksisiklin   Abstract: Condyloma lata is one manifestation of secondary syphilis caused by Treponema pallidum. It is described clinically as multiple whitish or gray papules found in warm and moist areas. Syphilis requires serious attention since it still remains a risk factor of human immunodeficiency virus (HIV) transmission all around the world. We reported a case of a 21-year-old male suffered from condyloma lata on his penile, scrotal, perineal, and perianal regions for 2 months and treated with 30 days course of 100 mg doxycyline two times daily. Early serologic examinations revealed reactive values of VDRL test (1/256), RPR test (1/512), and TPHA test (1:5120). Significant improvement was observed after 30 days course of doxycyline therapy where all lesions have resolved. Further serologic examinations as follow up showed a fourfold titre decrease of VDRL test (1/64), RPR test (1/128) and sixfold titre decrease of TPHA test (1/640) 3 months after the initial therapy. Conclusion: The diagnosis of condyloma lata in this case was established based on anamnesis, physical examination, and serologic findings. Treatment with doxycycline gave satisfactory result. Serologic examination as follow up needs to be performed at 6 and 12-months after the initial treatment to monitor the success of therapy. Keywords: condyloma lata, secondary syphilis, Treponema pallidum, doxycycline.

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